Skittles, Extra Strength
Vitamin C and Canker / Cold Sores
---Originally published in the print edition of The Boise Weekly, February 28, 2007---

Dear Dr. Rabin:
With illness running amok in our office, a colleague and I were discussing various symptoms and which ones are clear signs of an oncoming flu or cold: sore throat, body aches, headaches and canker sores. Canker sores? Said colleague claims a canker sore (or five) are always the first indicator that he's getting sick. I told this worker pal of mine that the surest way to cure a canker sore is to apply Vitamin C powder directly on the sore and it will be gone within a day. I know that it works, but I don't know why. Can you elucidate?
--Amy Nicole

I’m not often acquainted with the senders of questions, but this email is from a friend. In a follow-up conversation, I learned that the long-suffering co-worker applied not Vitamin C powder, but Sour Skittles candy to his sore – yet still got the intended healing effect. Apart from some easy wisecracks, this act clearly demonstrates the human inventiveness that sometimes leads to important discoveries. Arguably, significant recent finds include duct tape’s usefulness for removing warts and Preparation-H’s facility for hiding wrinkles. As much as I encourage this sort of experimentation, one still must wonder about the reasoning of the guy who discovered that a little urine takes the bite out of jellyfish stings.

Canker sores, those extremely painful mouth ulcers, typically arise after a pinpoint tingling or burning sensation. Their cause is still a matter of some debate, but they commonly follow minor mouth wounds from things like sharp bread crusts, accidental cheek bites, or a late-for-work toothbrush stab. In full flower, the canker sore becomes a pale yellow ulcer about a half-inch wide, surrounded by an angry red ring. Singly or in clusters, they can be agonizing enough to make speaking, eating or even drinking plain orange juice worthy of a segment on MTV’s Jackass. 

These lesions are very different from cold sores, though the two are often confused. Canker sores occur inside the mouth on the soft, movable tissues like the cheek, under the tongue or in the pockets above and below the gums. Cold sores, on the other hand, erupt outside the mouth on the lips, chin or near the nose, and begin as tiny pustules. Unlike canker sores, cold sores are contagious and are caused by a virus (or, possibly, by a date with anybody on Viva La Bam). Both do share, however, the unfortunate characteristic of emerging at times of stress, fatigue or illness. 

A typical canker sore heals in about 10 days regardless of most treatments. When the number or severity of ulcers compels medical care, medications range from simple numbing agents to peroxide rinses or steroid creams. Home remedies often mimic the prescriptions (diluted hydrogen peroxide, Milk of Magnesia mixed with Benadryl, etc.) and appear to be only marginally useful. In spite of little supportive research, large numbers of people supplement with the amino acid L-lysine to prevent or treat both canker and cold sores. And a few, it seems, supplement with Skittles. 

Though I first scoffed at your Vitamin C powder cure, it appears that one of the most effective new treatments involves a similarly acidic substance. A compound containing sulfuric acid called Debacterol has been tested against a widely prescribed anti-inflammatory ointment. The results show participants had significantly less pain with 80% of ulcers healing within six days, not ten. Of course, applying a caustic material to an open sore seems like something only Johnny Knoxville would do, but this masochistic act may seal the ulcer against normal mouth bacteria and encourage faster healing. Both the citric acid coating on Sour Skittles and the ascorbic acid you recommend (Vitamin C) likely function in a similar way. 

Some home remedies, too, have happened upon this process. Table salt, alum (used for canning) and the nearly extinct styptic shaving pencil have all been recommended for canker sores. Note, please, that care must be taken with this endeavor; one or two applications are – you should forgive the pun – good and plenty. And, any mouth sore that lasts for longer than two weeks should be evaluated by a medical professional. 

Evidently, preventing canker sores is notoriously difficult. It takes a stronger person than me to pass up scratchy foods like potato chips and crusty bread. So even with my inevitable canker sore or some other food-related injury, I’m unlikely to be as creative as your colleague at improvising a quick treatment. That said, if a jellyfish ever stings me, I pray I’m with him and not with Steve-O.

"The Antidote" was a weekly column published from July 2005 to March 2008. Dr. Rabin tackled the hype surrounding alternative medicine, folk treatments, miracle supplements and cures-for-all-ills. His skeptical, evidence-based approach did not earn him many friends among local practitioners and multi-level marketers, but his monthly salary of two movie tickets made it all worth it.

Dr. Ed Rabin, Chiropractor

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Dr. Ed Rabin, Chiropractor  500 W. Idaho St., Suite 240, Boise, ID 83702  (208) 955-7277